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Meconium Birth Injury

Meconium is a dark green fecal material produced in a fetus’s intestines before birth. After birth, the newborn child passes these meconium stools for the first few days of life. During prolonged labor or a difficult delivery, an infant may experience stress, which may cause the baby to pass the stool while still in the uterus. The stool then mingles with the amniotic fluid that surrounds the fetus, causing the baby to breathe in or ingest the mixture of meconium and amniotic fluid just before or right after birth.

This is a condition known as meconium aspiration syndrome or MAS, which may cause significant health complications for a newborn child and if left untreated, may even lead to death. Meconium aspiration syndrome is preventable with proper prenatal monitoring. If a difficult or long labor is anticipated, doctors should order a Cesarean section or C-section to prevent these and other potential complications.

If your child’s birth injury was caused by meconium aspiration syndrome, it is important that you contact an experienced New York City birth injury lawyer at once to obtain more information about your legal rights and options.

How Meconium Aspiration Occurs

Meconium is the first bowel movements a child has after birth. Meconium is a thick, green substance, which is normally stored in the baby’s intestines until after birth. However, in some instances, while the baby is still in the uterus, the meconium is expelled into the amniotic fluid, either during or before labor. This may happen when the child is experiencing some type of distress.

Once the baby passes the meconium and it becomes mixed in with the amniotic fluid, the child may inhale meconium deep into the lungs causing airway blockage and constriction. This reduces oxygen supply to the child and causes the airways to become inflamed. Often, this leads to pneumonia. Meconium aspiration also tends to occur after labor when a child inhales the meconium and amniotic fluid that is covering his or her body.

When meconium aspiration does occur, it is crucial that the medical team responds promptly and efficiently to restore normal breathing and minimize the complications associated with meconium aspiration. Very often, emergency resuscitation efforts are necessary to normalize the baby’s breathing and heartbeat. Medical staff must be equipped to deal with meconium complications and be prepared to handle this type of emergency.

According to Johns Hopkins medicine, Meconium aspiration syndrome is one of the leading causes of birth injuries, occurring in 5 to 10 percent of all births. Failing to prevent or properly manage meconium aspiration may lead to hypoxic ischemic encephalopathy (HIE), which may cause cerebral palsy and irreversible brain damage.

Symptoms of Meconium Aspiration

Here are some of the common symptoms and signs of meconium aspiration syndrome:

  • Greenish or yellowish appearance of the amniotic fluid.
  • The baby is not breathing or has difficulty breathing after birth.
  • The baby’s skin turns blue (this condition is known as cyanosis).
  • Fetal heart rate is fast or slow.
  • Low Apgar score. An Apgar score refers to the assessment of the newborn soon after birth, which takes into consideration factors such as the baby’s skin color, pulse rate, reflexes, muscle tone and breathing.
  • The child’s blood at the time of birth is acidic.
  • Meconium is found in the baby’s trachea.
  • A larger than normal rib cage.
  • Child appears weak at birth or limp.
  • Green or yellowed skin and nails.

Common Causes of Meconium Aspiration

Meconium aspiration is generally associated with a fetus that is in distress during labor. When the fetus is distressed, its intestines may contract allowing the meconium to prematurely pass into the amniotic fluid. Here are some of the common causes of stress, which may lead to meconium discharge and contamination of the amniotic fluid.

Overdue Babies

Meconium aspiration syndrome is extremely common in babies who are delivered at or after term. This is because the aging placenta wears out over the course of 40 weeks and loses some of its ability to deliver oxygen-rich blood to the fetus. This may cause fetal stress and lead to the premature expelling of the meconium.

Also, infants who remain in the womb past term have more developed reflexes. Therefore, they are more likely to release meconium. In addition, post-term babies are larger and have less amniotic fluid around them. This means that when the amniotic fluid becomes contaminated by meconium, the concentration of meconium in the fluid is higher and the baby is more likely to breathe it in and be affected by it.

Umbilical Cord Complications

During the pregnancy, the umbilical cord carries vital nutrients and oxygen from the mother to the fetus and nourishes it in the womb. If the umbilical cord is compressed, the flow of nutrients from mother to child is diminished. This may cause fetal stress and the premature release of meconium. Cord compression may also occur as the result of the baby’s position in the womb. The cord may get trapped between the baby and the mother’s pelvis or the wall of the womb. The doctor and medical teams should monitor closely and ensure that the umbilical cord stays free during delivery to prevent any issues.

Prolonged or Difficult Labor

Even without any additional or related complications, labor is stressful for the mother and baby. A prolonged labor or labor fraught with issues invariably leads to a situation where they both experience an extraordinary amount of strain. The baby, which has been sheltered in a warm and stable womb is suddenly squeezed by contractions and forced through the birth canal. The longer the duration of the labor, the more stress the baby experiences and the likelihood of premature meconium release becomes greater.

Labor may be prolonged for a number of reasons. One of the most common factors here is when the baby is too large to pass through the mother’s pelvis easily. Large babies (a condition known as macrosomia) whether due to maternal diabetes, maternal obesity or genetic conditions may be prone to prolonged labor. In some cases, the mother may have a narrow pelvis, which makes it difficult for the child to pass through the birth canal. Labor may also become prolonged or difficult if the baby is in a breech or feet-first position instead of headfirst. When babies are at a headfirst position, it is usually much easier for them to pass through the birth canal. A breech position may make the delivery more complicated and stress the baby into releasing meconium.

Maternal and Fetal Health Issues

The mother’s health and history of health issues may have a significant impact on the baby. There are times when maternal health issues such as hypertension or diabetes (often exacerbated by labor) can cause enough stress to the fetus leading to meconium being expelled.

In some cases, the child might experience distress in the womb because of health issues. For example, if the child has abnormally high blood pressure or an underdeveloped circulatory system, there is a higher likelihood of meconium being released in the womb. While fetal health issues alone don’t cause meconium release, the stress of labor combined with those health issues may cause the meconium to be released into the womb.

Diagnosis and Treatment of Meconium Aspiration

Meconium inhalation may be confirmed by listening to the baby’s chest with a stethoscope. Any abnormal breathing sounds may mean the child is having trouble breathing due to meconium aspiration. Blood work may help show that the baby’s blood is acidic or has low oxygen. Meconium aspiration may also be diagnosed with a chest x-ray. If the lungs appear overinflated or if the heart appears larger than normal, this may signify meconium aspiration as well.

It is very important that the medical team diligently monitors the fetus especially if the child is at risk for meconium aspiration. If the child is not receiving enough blood or oxygen or if the baby’s heart rate is slow, doctors must act quickly to restore oxygen supply. If this cannot be done, a C-section should be performed right away. A failure to properly monitor the baby or a delay in performing an emergency C-section can cause significant brain damage or even death.

Here are some of the common ways in which meconium aspiration is treated:

Ventilator: Nearly half of the babies with meconium aspiration syndrome need a machine called a ventilator to help them breathe. Because their lungs are partially collapsed and their airways may be obstructed and inflamed, they need a ventilator to control the oxygen and carbon dioxide levels within the baby’s blood. In some cases, supplemental oxygen may be delivered through a face mask or oxygen hood.

Clearing the airways: Another way to treat meconium aspiration is to do a procedure called suctioning, which helps deep clean the airways. A child that has inhaled meconium will typically have slow breathing, slow heart rate and low muscle tone.

Intensive care: When a child shows signs of breathing problems, he or she should be admitted to the neonatal intensive case unit for close monitoring. The child needs ventilation and blood pressure monitoring as part of his or her treatment after delivery to avoid further complications or serious birth injuries.

Therapies: There are a number of therapies, which can be administered to children who have suffered meconium aspiration. Drugs containing surfactant, a substance that helps decrease tension in the lungs, may be given to babies with meconium aspiration syndrome. This helps improve lung function and helps the child breathe easier. Meconium also causes the airways to become inflamed. Providing steroid treatment for children with meconium aspiration syndrome may help bring down the inflammation and improve lung function. Inhalation of nitric oxide may also relax the vessels in the lungs and assist the child’s breathing.

Filing a Birth Injury Lawsuit

If you have prolonged labor or a complicated delivery, your doctor and medical team have the responsibility to help you make the safest and most effective choice. Constant fetal monitoring is absolutely essential in cases where risk factors for meconium aspiration are present. If your doctor had sufficient information to know that a C-section would have been less risky or if your medical team failed to take the necessary steps to promptly treat meconium aspiration and your child suffered birth injuries as a result, you may have grounds for a medical malpractice lawsuit. You may be able to seek compensation for damages including, but not limited to, medical expenses, loss of future income, loss of livelihood, cost of continuing treatment, rehabilitative therapy, permanent injuries, disabilities, past and future pain and suffering, etc.

If your child has suffered birth injuries as the result of meconium aspiration syndrome or MAS, the experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you.

One of our clients secured a $43,940,000 verdict for a child who was diagnosed with cerebral palsy. The hospital failed to diagnose fetal distress, which led to brain damage and cerebral palsy from lack of oxygen supply to the brain. The delay in diagnosing the fetal distress and ordering a C-section delivery caused the child’s condition. Defense attorneys argued that the child’s injuries were caused by premature birth and that the obstetrical care was appropriate. The $43,940,000 verdict was eventually reduced on appeal, because the verdict was so huge.

In another case, our client obtained a $4,500,000 settlement where the doctor negligently used forceps to deliver a baby cutting oxygen supply to the child’s brain. The infant suffered from cerebral palsy as a result. It was proven that a C-section should have been performed, which may have prevented the cerebral palsy from occurring.

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Sources:

https://www.hopkinsmedicine.org/healthlibrary/conditions/adult/pediatrics/meconium_aspiration_syndrome_22,MeconiumAspirationSyndrome

https://kidshealth.org/en/parents/meconium.html

 



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